Blues plans are launching a high-performance network nationwide.
The Blue Cross Blue Shield Association (BCBSA) revealed this week that its member plans would offer Blue HPN beginning in January 2021. The network will be available in 55 markets across the U.S.
Jennifer Atkins, vice president of network solutions at BCBSA, told FierceHealthcare that the goal in launching the network was to build on the plans' existing value-based and patient-centered models.
“As we pulled the plans together to work on this national profile, we found we have a lot of commonalities in our existing value-based arrangements,” Atkins said.
There was strong interest in the individual markets for such a network, she said. About 70% of members in BCBSA plans are enrolled in a value-based contract.
Employers are taking a more “activist” role in healthcare, and part of that effort includes greater uptake of options such as direct contracting and high-performance networks to drive lower costs without pushing additional cost sharing for employees.
Atkins said that existing value-based contracts deliver an average of 10% in total cost savings on top of savings in the Blue PPO, BlueCard, and that the BCBSA members expect a high-performance network to grow that number further. With 74 million members in its base, Atkins said the Blues plans believe they can reach the “critical mass” necessary to gather quality providers.
In developing the networks, the plans will take a “best of local” approach that allows each plan to meet the needs of its markets under a shared set of standards. Quality metrics focus on offering the appropriate care, promoting adherence and boosting outcomes, and Blue HPN allows for individual plans to build in their own metrics to fit regional needs.
“At the end of the day, we’re looking for providers who are really focusing on the overall health of the population and members, improving outcomes and being willing to take steps along this journey with us,” Atkins said.
The experience for members enrolled in Blue HPN is also highly local, Atkins said. The Blues insurers will work closely with employers to ensure that communication is clear and workers can understand what their plan entails.
A key concern in a narrow-network plan is that members may not have a full grasp of what’s covered, which could put them at greater risk of unexpected medical bills that they cannot afford.
"We have been working hard to ensure that when we’re communicating to employees through employers that choose the high-performance network they can be confident that they’re receiving the best care at the best price,” Atkins said.